# Trauma nurses' experience of repositioning practice for trauma patients: a qualitative descriptive study

## TL;DR

This study explores how trauma nurses in Saudi Arabia decide to reposition patients, finding that clear policies, teamwork, and resources are key to preventing pressure ulcers.

## Contribution

The study provides new insights into the factors influencing trauma nurses' repositioning practices in emergency and ICU settings in Saudi Arabia.

## Key findings

- Clear policies, teamwork, and managerial follow-up influence nurses' repositioning decisions.
- Delays in medical decisions and heavy workloads often lead to repositioning being omitted.
- Skill gaps and lack of equipment hinder nurses from completing repositioning even when intended.

## Abstract

Clinical evidence indicates that the low frequency of repositioning among trauma nurses contributes to pressure ulcers during hospitalization.

This study aimed to understand how trauma nurses address the need for repositioning patients in an emergency room and intensive care unit in Saudi Arabia.

A qualitative descriptive design was employed, and the study was reported in accordance with COREQ guidelines and checklist. Semi-structured interviews were conducted with nurses to explore how they interact with the need for repositioning patients. Rigor was ensured using the criteria established by Lincoln and Guba.

Fifteen nurses from a large government hospital in Saudi Arabia participated in the study. The findings revealed that the policy's clarity, the presence of teamwork, and the level of managerial follow-up influenced nurses' decisions to proceed and perform repositioning. This procedure is often omitted due to delays in medical decision-making and workload. After deciding to proceed, factors such as nursing skill and the availability of the equipment influence repositioning practice.

Clear policies, timely medical decisions, teamwork, manageable workloads, and managerial follow-up are critical in nurses’ decisions to perform or delay patient repositioning. After deciding to proceed, nurses face a second critical step: assessing their abilities, equipment availability, and the patient’s needs. Even with the intent to reposition, perceived skill gaps and inadequate equipment can significantly reduce the likelihood of completing the procedure.

Hospitals should support the processes by improving policies and the care system for trauma patients. Repositioning is the cornerstone of pressure ulcer prevention among trauma patients; therefore, work system-level changes are needed to ensure compliance.